Apocynum Cannabinum

A. cannabinum, L.

Nat order , Apocynaceæ.

Common name , Indian hemp.

Authorities. [No.

1 , from Lond. Med. Gaz., 1833 (A. H. Z., 4, 870); 2, N. A. J., 4, 529; 3, "Peters's Elements;" 4, An Inaugural Dissertation on Indian Hemp, etc., to the Jefferson Med. Coll., by M. L. Knapp, 1825.]

1 , Black; 2 , Peters; 3 , Marcy; 4 , Knapp (took infusion of the powdered root in warm water (15 grains to cupful), two tablespoonfuls every fifteen minutes).

MIND

• Bewildered, 4.*

HEAD

• Unusual heaviness of the head, with aching pains in the small of the back and limbs (evening, eighth day), 8.
• Headache, 4.

EYE

• Woke early in the morning, with severe irritation of the left eye, as if several sharp grains of sand were in it, attended with much heat, irritation, and redness; after lasting several hours, this disappeared as suddenly as it came on, 2.

NOSE

• Without any other sign of having taken cold, he would wake up in the morning with the nostrils and throat filled with thick, well-concocted yellow mucus, as if he had a severe catarrh for at least seven or ten days, and which had skipped its first stage and commenced in the second, 2.

MOUTH

• Dryness of mouth on waking (fifth morning), 3.
• Increased secretion of mucus and saliva from the mouth and fauces, which kept me constantly spitting, 4.

THROAT

• The bitter subacrid taste was persistent in the fauces, 4.

STOMACH

• Thirst on waking, 3.* [10.]
• Slight nausea (fifteen minutes), 4.
• Nausea, 3.
• Efforts to vomit (thirty minutes), 4.
• Nausea, and even vomiting, 1.
• After sleeping an hour, woke with extreme sickness, followed by two spells of full vomiting (two and a half hours), 4.
• Vomited slightly (one and a quarter hours), 4.
• On waking, felt a sinking at the stomach, 3.
• Occasionally, a sense of sinking at the pit of the stomach, 2.

ABDOMEN

• Decided distension of the abdomen , especially after a moderate dinner; all the sense of fulness seemed about the stomach, liver, and spleen, while the lower bowels did not appear more flatulent than common, 2.
• Occasionally, some flatulence and slightly uneasy sensations in the bowels, 2.

STOOL AND ANUS. [20.]

• Occasionally, it seemed as if diarrhœa would occur, but it did not, 2.
• It proved a gentle cathartic; "I felt the stimulus of it passing onward into the intestines;" a gentle movement the next morning without any griping, and the bowels were kept soluble for a day or two, 4.
• Loose, but not very copious, bilious stools, 2.
• Increased inclination towards constipation, 2.
• Evacuations exceedingly scanty, 2.*
• Bowels sluggish, but fæces not hard or costive, 2.

URINARY ORGANS

• There seemed to be but little expulsive power about the bladder, 2.
• The little water that was passed flowed as easily as if it were oil, 2.
• Copious secretion of urine, 1.
• Urine augmented, 4. [30.]
• Urinary secretion increased in quantity, and much lighter in color than in health (eighth day), 3.
• Diminished urine (sixth day), 3.*
• Decided scantiness of the urine, 2.*
• Urine diminished to one-third the usual amount , without pain or uneasiness about the kidneys or bladder; on the contrary, these organs seemed remarkably comfortable; they seemed simply torpid, 2.*
• Urine generally of a light, golden, sherry-yellow color, not depositing any sediment from exposure to cold, 2.

RESPIRATORY APPARATUS

• Short dry cough, 3.*
• Once during the evening, and twice upon different nights, sudden and violent attacks of hard and frequent coughing, annoying him for at least one or two hours, then disappearing without leaving a trace of cold behind, 2.
• Scanty expectoration of white mucus, 3.
• Irresistible disposition to sigh, 3.
• Short and unsatisfactory respiration, 3.* [40.]
• *Sense of oppression about the epigastrium and chest, several times so great that there was the greatest difficulty in getting breath enough to smoke a cigar or to speak with any comfort, and this happened after lighter meals than ordinary, 2.

HEART AND PULSE

• Pulse, between attacks of vomiting, 45 (two and a half hours), 4.
• Pulse 50 (one and a half hours), 4.

NECK AND BACK

• Slight soreness in the region of the kidneys, when bringing the muscles into action, 3.

LOWER EXTREMITIES

• Hard aching several times in both knees, sufficiently severe to make him fear that an attack of inflammatory rheumatism was coming on, 2.

GENERALITIES

• General restlessness on going to bed, 3.
• Weak and sleepy, and went to bed (one and a quarter hours), 4.
• Sense of general but transient debility, 2.
• Though it diminished the pulse, it produced no deathlike prostration, 4.

SLEEP AND DREAMS

• On going to bed, desire to sleep, without the ability to do so, 3. [50.]
• Great restlessness and little sleep (fifth night), 3.
• Drowsiness, 4.

FEVER

• On going to bed, unusual heat of the skin, 3.
• Sweat, 1.

CONDITIONS

• Aggravation.
• ( Morning ), Early, on waking, irritation of left eye, etc.; on waking nostrils and throat filled with mucus; on waking, dryness of mouth; thirst; nausea; sinking at stomach.
• ( Evening ), Heaviness of head, etc.; attack of cough.
• ( Night ), Attack of cough.
• ( Going to bed ), General restlessness; desire to sleep, etc.; heat of skin.
• ( After dinner ), Distension of abdomen.
• ( Exerting muscles of the part ), Soreness in region of kidneys.

SUPPLEMENT: APOCYNUM CANNABINUM.

Apocynum Cannabinum. John H. Griscom, M.D., Am. Journ. of Med. Sci., vol. xii, 1833, p. 55. General effects.

Its first operation when taken into the stomach is that of producing nausea if given in sufficient quantity (which need not be large), and if this be increased, vomiting will be the result. It very soon evinces its action upon the peristaltic motions of the primæ viæ, by producing copious feculent and watery discharges, particularly the latter, which action when once excited is very easily continued by the occasional administration of a wineglassful of the decoction. The next operation of this remedy is upon the skin, where it displays its sudorific properties often in a very remarkable manner. Copious perspiration almost invariably follows its exhibition. The activity of its diuretic properties does not appear to be so great in many instances as in others. As a sternutatory also it has a very powerful effect, as I have experienced in my own case; the fumes, on one occasion, produced not only long-continued and violent sneezing, with an increased discharge from the Schneiderian membrane, but were unquestionably the exciting cause of an attack of erysipelas of the face and head.

Proving N°1.

--Apocynum cannabis. Essay, submitted to the Faculty of Hom. Med. College of Penna., by Wm. T. Helmut. 1853. Proving.

The tincture was obtained by digesting the fresh root in alcohol, and afterwards expressing the juice.

Shortly after talking half a teaspoonful of the tincture, a feeling of nausea was experienced, which seemed to commence at the throat, and extend downward to the stomach; this symptom continued for nearly an hour, however there was no inclination to vomit. There was an accumulation of water in the mouth, causing constant expectoration of a thin transparent fluid, after which there was dryness of the fauces. The fancy became exalted, with a flow of good spirits, well pleased with every one; in about an hour this gradually died away, leaving a pain in the forehead, particularly above the superciliary ridges, of a heavy drawing character, together with throbbing of the anterior temporal artery; great drowsiness, with drooping of the eyelids; at times rumbling with darting pain in the lower part of the abdomen. About 12 M. these symptoms had almost disappeared, when another teaspoonful of the tincture was taken, producing the same effects as those noted above, only in an aggravated degree, together with a constant desire to urinate, the urine passing very copiously and freely. On awaking the next morning a severe bruised sensation was experienced in the limbs, all the joints, and particularly in the small of the back, almost impeding motion, which disappeared after walking.

The bladder seemed much distended, and after evacuating the urine, which was very turbid and hot, a thick mucous sediment was thrown to the bottom of the chamber. The urine after being voided left a burning in the urethra, which continued nearly half an hour.

All the next day (Jan. 5th), there was experienced headache, and a discharge of a thin watery fluid from the urethra; the pain in the head was confined to the vertex and forehead and was throbbing in character; there was also vertigo when rising, but particularly when yawning or stretching; pain at times in the left eye, as though it were wearied, with drooping of the eyelids. Coldness was sometimes perceptible in the hands and feet. Frequent call to stool, four or five times during the day; the stools were soft and copious, being passed with little pain, with a general feeling of relaxation. Discharge of much urine, with the same sediment as before mentioned which was found to coagulate by heat, and in very many respects resembled albumen.

The tonsils and throat, for a day or two, seemed coated with mucus which had dried upon them.

Proving N°2.

--Dec. 15th, 10 P.M. 1 drop in a teaspoonful of water. Slept as usual.

Dec. 16th, 9 A.M. One hour after breakfast, dose as before. Immediately after taking a slight burning sensation on the red part of upper lip. Slight nausea, which soon disappeared. Two hours after each meal there was experienced a very distressing oppression at the epigastrium; also a sensation as if there were a working in the stomach: This symptom lasted about two hours, and then disappeared.

Dec. 16th 9 P.M. Two hours after a meal, dose as before. Slept as usual.

Dec. 17th. Morning before breakfast, 2 drops in a tablespoonful of water. The same sensations at the epigastrium as yesterday. Evening, 2 drops as before. Here it was taken purposely on an empty stomach to ascertain positively if the effects produced would be similar to those previously experienced. About ten minutes after taking it a similar sensation of distress at the epigastrium was experienced, and to such a degree as to compel me to leave my sitting posture and walk about, which gave me some relief. In the evening after taking the drug, about three hours a meal, not so much inconvenience was produced as when the medicine was taken on an empty stomach.

Dec. 18th. After breakfast, dose as before. Felt better to day; distress at epigastrium less. 9 P.M., 5 drops in a teaspoonful of water; soon after taking it a sensation of working in the stomach, as from wind, with empty eructations, after which relief was experienced; slight pinching pains in the epigastrium, shooting from right to left. Slept as usual.

Dec. 19th, A.M. and P.M. 5 drops two hours after meals. No marked impressions, save the epigastric symptoms were about the same.

Dec. 20th. Five drops two hours after breakfast; slight nausea soon after talking the drug, which was of short continuance. Felt less distress at the epigastrium today. P.M., 10 drops in a teaspoonful of water, soon after there was a rumbling in the abdomen, and the peculiar sensation of working in the stomach; several short pinching pains across the middle of the abdomen. Sensation as if a ball were pressed against the inside of the stomach, at the pyloric region. Slept as usual.

Dec. 21st. No medicine. Felt uncomfortable today, on account of above sensations.

Dec. 22d. No medicine. Symptoms beginning to disappear.

Apocynum cannabinum. Edward Chapin. Thesis presented for the gold medal N. Y. Hom. Med. College, 1878.

Proving of Louis Faust , M.D. -Age twenty-one years. Normal pulse 66. Normal amount of urine passed every twenty-four hours, thirty fluid ounces. Average specific gravity of the same 1028. Color of hair brown; dark complexion; eyes gray. Habit, strictly temperate.

Commenced the infusion of the tops of the fresh plant July 20th, 1877 at 3 P.M.; took 1/2 oz. with no effect.

July 21st. At 8.15 A.M., took 1 oz. Soon after slight nausea, which soon passed away. At 11.10 A.M. burning pain in the stomach, causing me to feel uneasy. Shooting pain in right ear, lasting over one hour. (Have never before been troubled with earache). Urine for the twenty-four hours 40 ozs., and specific gravity 1020. At 4 P.M. took 1 1/2 ozs.

July 22d. Took none. Urine passed during twenty-four hours 36 ozs., specific gravity 1022.

July 23d. At 5 P.M., took 2 ozs. Soon after singing I had partial deafness in left ear, which continued over one hour, with occasional sticking in same ear. Urine for twenty-four hours 24 ozs., specific gravity 1025.

July 24 th. Was restless all night; have had temporal headache all day with heaviness and pain in my eyes, as if I had use them too much, although I have used them more than usual. At 4.30 took 2 1/2 ozs. Urine, twenty-four hours 30 ozs.; sp. gr. 1028.

July 25th. Same heaviness over eyes as yesterday. Have had ravenous hunger since commenced proving. Get hungry an hour before mealtime. Bowels have a tendency to be loose. At 7 P.M. took 3 ozs.

July 26th. While a breakfast was taken with violent pain in abdomen which continued until I had a passage. The stool was very soft, painless relief after stool, but have felt weak all the morning. Face pale, with cold perspiration. Rumbling in the abdomen. Urine, twenty-four hours, 42 ozs. sp. gr. 1024. No medicine.

July 27th. Passed a very restless night. Have an uneasy feeling in my abdomen, but no tendency to stool. Urine, twenty-four hours, 23 ozs.; sp. gr. 1026.

July 28th. Great weakness with my stomach. Although I eat hearty meals I get hungry long before the next. Bowels still loose, they seem to be loose generally in the morning, as I have had no passage in the afternoon since proving. Stools painless. Urine, twenty-four hours, 24 ozs.; sp. gr. 1028.

July 29 th. Same uneasiness in stomach. Urine, twenty-four hours 34 ozs.; sp. gr. 1022.

July 30th. The uneasiness and weakness in stomach have increased to a gnawing this P.M.; it commenced about an hour after dinner. I feel as though I was constantly being threatened with an attack of cholera morbus (I am very careful in my diet). Urine, twenty-four hours, 24 ozs.; sp. gr. 1028.

July 31st. Bowels are natural, but the same sensation of gnawing and hunger continues in stomach. Urine, twenty-four hours, 24 ozs.; sp. gr. 1028.

August 1st. Although I ate a hearty breakfast I have now (10 A.M.) that gnawing in my stomach. Urine, twenty-four hours, 34 ozs.; sp. gr. 1020.

August 2d. Feel well to-day. The gnawing and hunger have left me. Bowels are natural. At 5 P.M. took 2 1/2 ozs. Immediately after nausea, which soon passed away.

Had peculiar sensation in thorax, causing me to sigh constantly.

Proving of Byron E. Mead , med. student, age twenty-four. Weight 148 lbs. Height 5 ft. 5 in. Sanguineous temperament. Hair black. Complexion fair. Eyes black. Temperate in habit. Pulse full and strong, average about 73 beats per minute. At the time I began this proving, was in a good state of health. Bowels regular, one passage per day, stool of ordinary size; for urinary record see tables at the end.

Preparation, cold infusion of the fresh root.

June 19th, 1877. At 10 P.M.; took 1/2 oz. Retired at 11 P.M., having felt no effect from dose. Slept well during the night, and on waking in the morning felt rested and refreshed, and ready for my morning meal.

June 20th. At 7.30 A.M. took 1 oz. upon going to breakfast. No effect. At 8.30 took 1 oz. About one hour after taking last dose felt sick, with an inclination to vomit; also frontal headache, pains darting, passing from one temple to the other; first, from left to right, and vice versâ . At times feel dizzy, sensation as if I was going to tumble over.

Vertigo coming quickly , and passing away as suddenly. This last named symptom is a very marked one in my case, as I am never subject to vertigo unless it can be traced to some definite cause. I also fell dull and unable to think well. Cannot fix my thoughts on any one subject, and retain them for any length of time. At 11 A.M. took 1 oz. Symptoms same as before, excepting the nausea, which was more marked and remained longer.

Hot infusion of the root. (Had no more of the cold).

June 20th. At 1.30 P.M. took 2 ozs. of hot infusion of root, and at 2.20 P.M. was taken suddenly with intense tenesmus , and the desire for stool so great that I was compelled to leave the drug-room and get to the water-closet as soon as possible. Stools large and light yellow, accompanied by rumbling in the bowels, and flatus. Ther seems to be almost complete loss of power of the sphincter muscles of anus. After stool, considerable nausea and frequent desire to vomit, but did not. At 5 P.M. passed another large stool, accompanied by great rumbling in bowels, and flatus. Also frontal headache, with sharp, darting pains. Pain in right shoulderblade. General muscular weakness. Feeling of lassitude. At 6 P.M. took 2 ozs. After taking the dose went to dinner, and while there was taken short, and passed an exceedingly large stool (in water-closet) light yellow, fetid, with great flatus and the same rumbling of the bowels. Same frontal headache, and constant flashes of heat; face looks flushed and hot. Respiration affected, slight suffocating feeling. Hungry all the time, could eat every hour in the day, relish all kinds of food, and seem to digest them well. Rheumatic pains in the joints. Increased action of the heart , fluttering at times, and sensation as if it would force its way out through walls of chest.

June 21st, 7 A.M. Have passed a good night, slept well, and feel refreshed, and ready to take my regular morning meal. At 10.30 A.M. took 2 ozs. About an hour after had a sudden desire for stool, and passed a large one of same color as before, and accompanied by same rumbling and flatus. Impossible to tell when I am through passing, for I get up from water-closet and think that I am through, and another pain takes me, compelling me to hurry and sit down again, and nothing passes but wind. No headache to-day, but considerable vertigo, feel as if I were going to tumble over. Pain in orbital region, and dull heavy feeling over the eyes. General lassitude. No ambition. Cannot concentrate my thoughts. Burning sensation in anus. Complete loss of power of sphincter muscles. At 1.30 P.M. took 2 ozs. About one half hour after had an urgent desire for stool, preceded by intense pain in bowels. Passed a large musty stool, and lots of flatus. Sphincters seem to be relaxed, and cease to perform their proper function. Urine burns when passing, and feels hot. Head dull, heavy feeling in forehead and heaviness over the eyes. Slight vertigo. Some pain in right shoulderblade, and in muscles of forearm. Cannot concentrate my thoughts. At 4.30 P.M. desire for stool, but in trying passed nothing but flatus. Slight dull pain in region of kidney. Slight palpitation of the heart. At 6.30 P.M. feel too tired to go to dinner, but am exceedingly hungry, and will go. Ate a hearty meal, and when I got through my hunger seemed unsatisfied. On returning, desire for stool, accompanied by flatus and rumbling; passed a large mushy stool, which was light yellow. Soreness and bearing down in rectum.

June 22d. Feel exceedingly weak this morning, limbs and muscles feel sore slept well last night, but do not feel rested. Appetite good. Had one passage this A.M. on getting up, and of the same nature as before. Burning in the anus.

Bearing-down sensation , inclination to hæmorrhoids.

• 6 P.M. Have not taken any medicine today. Have had four passages since morning, and feel weak and tired. Pain in joints nearly all day, also frontal headache.

June 25th. For the few days past my bowels have been loose, having from three to four passages per day, and nearly every one accompanied by flatus. Appetite good all of the time and no unpleasant effects after eating.

At 10.30 A.M. took 2 ounces cold infusion of tops. About an hour after felt sick at stomach, and desire to vomit. Frontal headache and vertigo. 1.30 P.M. Have just returned from lunch and feel urgent desire for stool, accompanied as before by rumbling in bowels and flatus. Stool large, thin and watery, bearing-down pain in anus, and soreness in rectum. General muscular weakness and inability for labor. Some frontal headache and very marked vertigo. 3 P.M. Desire for stool so intense that I had to run from the drug-room to avoid an involuntary evacuation; passed a large, thin yellow stool and a great deal of flatus. Soreness in rectum and bearing-down sensation. Strong inclination to vomit, but have not as yet. Pain in right shoulderblade and in muscles of forearm. Heaviness over eyes and general lassitude. At 6 P.M. Have just had another stool, but very small, and no rumbling in bowels. Sphincters still relaxed. Frontal headache and heaviness over the eyes. Increased heart's action and flushes of heat to the face.

June 26th. Slept exceedingly well last night, and feel rested this morning.

General Remarks.

• Have noticed that my bowels were loose for some two or three weeks after taking the drug, and I had two or three passages per day during that time. I have also noticed a bearing-down pain in rectum and strong inclination to hæmorrhoids. The relaxed condition of the sphincter muscles lasted for some three weeks. The effect on the system was so great that for months after the more smelling of the drug would make me fell sick at the stomach.

Proving of J. Clark, M.D.

-Age thirty-four. Height 5 feet 9 3/4 inches. Weight 155 pounds. Color of hair brown, of eyes hazel. Habit temperate. General health good. Complexion dark and of a bilious temperament.

Used θ of the whole fresh plant.

August 23d, 1877. At 6 P.M. began with 3j doses two hours; was called to an obstetric case and did not get second dose until 9.15 P.M., and then at 11.15 P.M.

• August 24 th. Took dose at 8 A.M., felt a slight burning sensation in stomach while at breakfast. Took it every two hours all day excepting at 2 o'clock. To-night have nausea almost to vomiting, and slight headache. Have an unpleasant grumbling in bowels, but not much pain with diarrhœa.

August 25th. Both this and yesterday morning had some vertigo on rising from stooping posture. Had furious diarrhœa last night, painless. I did not want to leave the water-closet when I was through, more from a sense of weakness than otherwise. Began this morning at 8 o'clock to take medicine. Don't feel very well this A.M. Abdomen feels as though I had drank large quantities of water.

Evening on the 25th. Have not felt well all day, sick at stomach again to-night. Had hiccough both last night and this morning. Have felt very tired and weary all day. Nausea worse at night about 7 or 7.30. Had a severe pain when walking, in lower part of left lumbar region. Did not take drug very regular to-day, I was too sick. Had three passages through the day but none last night.

August 26th. Commenced again to take medicine at 4 P.M. Have taken three doses and feel very sick. Want to vomit but can't.

August 27th. Stools thin, light lemon-yellow, mixed with mucus, large in quantity. Don't dare to pass wind or water for fear that fæces will pass; twice thought that I would allow wind to pass when a small quantity of fæces passed.

I lost confidence , and so quit. Have been very sick all day, so much so, that I have not taken any medicine since 12 o'clock, noon. Have been covered with slight perspiration. Stools this evening as well as during morning frothy, rather more watery; light yellow as above. Have felt weak and exhausted throughout.

August 28th. Was not called up to water-closet last night. This morning mouth dry, tongue sticking to roof of mouth. Still have a little nausea. Vertigo on rising from stooping position. Although twenty hours have passed since I took last dose, still when I thought I would allow a little wind to pass, fæces came instead. Stools still quite watery. One symptom I have noticed several times, viz., when urinating I hardly know when through, the urine still seems to want to pass, or dribble away. My bowels were not back to their natural condition for sixty hours or two and a half days.

APOCYNUM CANNABINUM. Proving by Alfred Wanstall, M.D.

-Aged twenty-five. Weight 163 pounds. Height 5 feet 8 1/2 inches. Pulse during health 54 to 60 beats per minute, at times intermitting. I kept no record of my pulse during the proving, as it is very variable, sometimes as low as 50 beats per minute, and I suffer with some heart symptoms, produced I believe by smoking. General health good, bowels regular. Color of hair brown. Eyes dark blue. Complexion dark. I am not easily influenced by medicine.

June 19th, 1877. At 9 P.M. took 1/2 ounce cold infusion of root. At 11 P.M. took 1 ounce of same.

June 20th. At 7.45 A.M., 1 ounce of same. Increased appetite, even hunger. Smarting and burning in urethra while urinating. At 8.30 A.M. took 1 ounce of same. One hour later feeling of fulness in forehead and vertigo, passed away in a few seconds. Passage from bowels this morning not as copious as usual, and more difficult of expulsion. (I am always regular in this respect). At 10.30 A.M., took 1 ounce of same. Dull frontal headache through the day. At 2 P.M., prickling and tingling in and lameness of the muscles of left scapular region, which lasted only a short time. Through the day marked feeling of general muscular weakness. At 5 P.M., small and mushy stool, preceded by much (not offensive) flatus.

At 5.15 P.M., took 2 ounces hot infusion of root (fresh). Since taking the last have dull heavy pain in the both sides of the face and nose, passing into the forehead, marked on the left side. 7.15 P.M., urgent desire for stool, passage very soft, not fluid, brown in color, not offensive, no pain. Great muscular weakness all the evening. 9 P.M., took 2 ounces of same. 10.45 P.M., took 2 ounces of same. 11 P.M. small diarrhœic passages, difficult of expulsion, accompanied with much flatus. Passage of much odorless flatus during evening. At 6 P.M., great itching of back, sides, and limbs; on going to bed found that my body was covered with large papules, same color as skin, red only when scratched, which does not relieve. (They are similar to hives). They appeared in greatest number on the lumbar region and around waist. Sleep much disturbed by dreams (not unpleasant).

June 21st. Hurried out of bed at 5 A.M., in order to have a small loose passage from bowels, repeated at least every twenty minutes until 8 A.M. Passages very small and loose, but not watery, accompanied with much flatus. At times expelled with difficulty, again with much force. Inability to tell whether I am about to pass flatus or fæces. Increased appetite. The eruption on body still present this morning, but less prominent and not itching. All the morning dull, heavy, sick feeling in stomach and abdomen. 12 M. Small watery stool with much flatus, followed by much soreness of anus. 2 P.M. Small watery passage with much flatus. To-night, feeling of great weakness and prostration, especially in all the muscles. Eruption itching again, but not as bad as previous night. 6 P.M. Pulsation in right hypochondrium, lasting several minutes; returned a number of times during the evening. Slept well.

June 22d. Feel well in every way; two passages from bowels to-day, small and natural.

June 25th. At 11 A.M., took 4 ounces of cold infusion of the tops, followed by great nausea, so that I had to lie down. 12.30 M. Vomited the medicine and contents of stomach. No further trouble. From the time I stopped taking the medicine until the first week in August, had two natural passages from the bowels each day; something unusual, as my habit in this respect previous to taking the medicine had always been one passage a day. In addition, I have suffered constantly with sensation of weight and pressure in the anus, so that after sitting fifteen or twenty minutes, I would feel as if the rectum protruded, and I would be obliged to get up and walk about. This condition continued until the first week in August, when I was attacked with protruding inflamed hæmorrhoids, which were so severe as to compel me to take my bed; my sufferings were very great for about forty-eight hours; no bleeding at any time, and the pain was if a wedge were being forced into the anus by blows from a hammer. The inflamed condition of the hæmorrhoids lasted three or four days, after which the tumor gradually disappeared, though I was compelled to wear a T bandage for more than two weeks, since which time I have enjoyed my usual good health, bowels moving once a day as formerly. The weight and pressure have entirely disappeared from anus. For urine, see tables at the end.

Proving of Edward Chapin, Medical Student.

-Age, twenty-nine years. Weight at this time, 150 pounds. Height, 5 feet 9 inches. Color of hair, brown; of eyes, gray. Dark complexion. Temperate in habit. Pulse soft and regular. Average beat about 75 per minute. Bowels move regularly each day. Stools of ordinary size, and inclined to be darkish. Urine, the average quantity passed every twenty-four hours for fourteen days during the months of June and July, was 29 fluid ounces. Average specific gravity for same time, 1025 5/7. Color and odor normal. Reaction acid. Average amount of urea passed per day, was 370.9 grains. I was in a good state of health when I commenced to prove the drug.

August 13th, 1877. Just before retiring took 50 gtts, of θ of roots. Felt considerable nausea when waking during the night.

August 14th. Took 60 gtts. of the same in the morning about 7.30 A.M. About twenty minutes after nausea; this continued and was aggravated after moving of the bowels. Immediately after the passage of bowels I felt as though everything in me had passed out. My whole abdomen felt empty. Sensation as if something was passing up colon, accompanied with a grumbling feeling, also felt as if something was passing through the liver. In the mean time the nausea was increased and I felt deathly sick; this was associated with flushes of heat in different parts of the body.

Very marked piercing pains in right temple, followed by vertigo. At 2.30 P.M. took 75 gtts. of same, after which some nausea; and at 4 P.M. took 90 gtts. of same; then nausea accompanied with similar head symptoms as those in the morning. At 8.45 P.M. took 100 gtts. of same.

August 15th. On rising felt a desire to evacuate bowels, preceded by much flatus. Went to water-closet and had a passage (uncommon for me at such an early hour). The stool was mushy, and was expelled with a rush and much flatus. After stool, feeling of much goneness through whole abdomen, and for quite awhile after passage pain in right temple, accompanied with vertigo, also ringing in right ear. An aching sensation in umbilical region. At 7.45 A.M. took 120 gtts. of same. Head symptoms continue, and at 8.45 A.M. had another passage from bowels, this also was expelled with force but no pain. Stool was profuse, mushy but thin, yellowish hue. Same sensation of goneness following stool, associated with the grumbling pain in umbilical region. Also the pain in right temple. the sphincter ani muscle feels relaxed. Headache now more general, the pain extending all through head, even to the orbits. The ache in the head is dull, confused, and the whole system feels much prostrated. At 5 P.M., took 200 gtts. of same, and at 10 P.M. took 3iij of same; felt some nausea before going to sleep.

August 16th. Awoke before 5 A.M. with a severe headache; had to get up and urinate. Bowels moved about 7 A.M. A very copious mushy stool, darkish brown, very fetid. Tenesmus very marked after stool, accompanied with aching pain in hypogastric region. Sensation of goneness, and feel as if thoroughly cleaned out. Dull heavy feeling in head immediately after stool. At 7.45 P.M. took 3iv of same. Severe sticking and piercing pain in right temple, soon followed by dull feeling in whole head. Great prostration, aggravated by motion. Pulse at this time 88. Flushes of heat in different parts of body. At 11 A.M., urgent desire to stool, which was expelled with force and much flatus; it was thinner than the preceding stools. At 6 P.M., the desire for stool was so urgent that I had to make great haste. The stool passed with the force and sound of a cork flying out when opening a bottle of champagne. The stool was thin and lemon-colored; I also noticed some undigested particles of food. The stools appeared frothy, owing to the great force with which they were expelled. The sensation of goneness and prostration accompanied each passage, also the head symptoms, especially the piercing pain in right temple. About 8 P.M., had another characteristic stool. When urinating could hardly tell when urine was passing. There seemed to be a weakness of the sphincter of the neck of the bladder. The urine at times would feel hot, and leave a tingling sensation in urethra.

August 17th. Has a very large stool, very thin and yellowish, and the last part contained undigested food. The sphincter ani muscles feel greatly relaxed. Anus feels open after passage of stool. The head symptoms and the feeling of goneness and prostration all very prominent. Had another stool in the evening, it was very large or copious, at first very thin, but towards the end it was mixed with fæces in small lumps.

August 18th. Had a very copious stool in the morning. It seems as though the gate was wide open, and everything in me had passed out. Stool was very thin and brownish. About an hour after had another stool of the same character. The pain in right temple after this stool was very prominent, also the great prostration of whole system. Some grumbling and disagreeable feeling in bowels. Inclination as if stool would frequently pass. These stools are expelled with force.

Second t est with θ of the fresh roots.

• August 29th, 1877. Took 1/2 ounce just before retiring. Slept very well.

August 30th. Took 1/2 ounce of same about 7.15 A.M. Bowels moved at regular time; first part of stool natural and latter thin. Had some tenesmus after stool. Weak feeling in abdomen and some rumbling. Passed much flatus. Flashes of heat followed by quite profuse perspiration. Spittle quite thick and tenacious. Expectorate considerable amount of white gelatinous mucus. Pulse 68. At 1.40 P.M. took 1/2 ounce of same. An aching pain in sacrum, and at times sharp and sticking, appearing occasionally in hip, knee, and ankle joints. Darting pains in different parts of bowels; feels as if wind or flatus was expanding the intestines. Pain in right temple, followed by confused and dull aching pain in head. Vertigo at times, and aggravated by ascending. Rumbling in bowels.

At 5.15 P.M. took 1/2 ounce of same. Soon after eating the lower part of abdomen felt distended. Perspiration quite profuse. After urinating felt a dull pain in the neck of bladder, also in the urethra; the pain in neck of bladder gave the sensation that the sphincters were trying to close but could not, thus showing an inactivity of these muscles. Had attacks of much, nausea, making me feel deathly sick. Could not vomit. Much Vertigo.

August 31st. Had quite a severe headache when waking. Restless during the night. At 7.50 A.M., took 1/2 ounce of same. A very large stool about 9 A.M., thin and brownish. Some flatus. No pain. Sphincter ani feels relaxed and there is loss of power. Aching pain in umbilical region after stool, also a feeling of great goneness, accompanied by pain, first in right temple, then extending through whole head, making it feel much confused. Vertigo. Pain again in knee joints, especially left. At 6 P.M. took 1/2 ounce. Some nausea. Head symptoms continue as before, followed by spells of marked vertigo.

September 1st. Stool in morning large and of a brownish hue, thin and watery. Feeling of goneness and grumbling-aching pain in umbilical region after stool. Urine expelled with little force, as if muscles were relaxed and had lost power of action. Pain in joints at times quite severe also pain in left scapula at inferior angle.

I stopped taking drug September 1st, and did not commence to prove again until September 28th, 1877.

Test with hot infusion of fresh roots containing 10 per cent. of alcohol . September 28th, 1877. Weight at this time 146 pounds. Respiration 17. Just before retiring, took 1/2 ounce of the above-named. Soon after much nausea, but no vomiting.

September 29th. Respiration 16. Pulse 68, and regular in morning. At 7 A.M. took 1/2 ounce of same. Nausea returned. A rumbling and weak feeling in lower bowel. Headache commenced in right temple, then sharp stabbing pains followed by confused feeling in head, and then vertigo. Aching pain also extends to meatus auditorius externus. Urine slightly acid. Stool easily evacuated and mushy at end of passage. Heaviness of rectum followed tenesmus after stool. At 10.30, took 1/2 ounce of same. Feeling of goneness. Severe pain in head. Arms, apparently loss of muscular power, feel as thought they could not be moved. Pains in joints reappear. At 2 P.M. took 1/2 ounce of same. About twenty minutes after the pulse 60. Dr. Boynton, Assistant Surgeon to New York Ophthalmic Hospital, thus describes the pulse: Full, irregular, slow, intermittent, dicrotic, three regular beats, then intermission, then two beats, then one; intermission, then one; intermission; then can count four beats; irregular; at times feeble, readily compressed then slow. A short time after, Dr. Wanstall, Resident Surgeon of same hospital, listened to chest and found that the heart was beating regularly for a short time, then fluttering occasionally and very feeble, and then it seemed to be slow and labored, now and then losing a beat; he also noticed a clicking sound, for which he could not account. During the afternoon and evening, felt slight darting pains in region of heart. A feeling of prostration of weakness near the heart. I would have to take a deep inspiration in order to get breath, for I felt so suffocated. After these sensations, flashes of heat followed by perspiration. Had stool, with much tenesmus. Heavy bearing-down feeling in rectum. At 5.20 P.M., pulse for first half of minute 18 beats, and last half 32, making a total of 50 per minute. Respiration 18. Pulse at 6 P.M., 66; had tracing taken at this time. The tracing showed marked intermissions. I had the pulse watched closely and it continued to intermit that day and night. The action of the drug on the heart was so violent that I was fearful of taking any more of it at this time. I did not know but paralysis of the heart would follow, as the pulse was reduced so much below its normal condition. Sleep this night not impaired. Symptoms aggravated by motion.

September 30th. On rising, the pulse at 60. Respiration 17. The pulse was now more full and regular than the previous day. Stool not normal but soft and mushy, and of a lemon color. Much flatus. Prostration after stool not as marked as when I first took drug several weeks before. Pain in the region of heart returned, accompanied with feeling of weakness in that region. Sensation as if heart beat slowly, then fluttered, and followed by regular beats. At times could distinctly feel impulse of heart against walls of chest. Sharp pain at intervals in inferior angle of scapula of left side. Head symptoms continue, but not as much vertigo. More or less aching in joints. Whole system feels weak.

TABLES OF URINARY ANALYSES

BYRON E. MEAD, Normal Under influence of drug

Amt. oz.

Sp. gr.

Urea, grs.

Date Amt. oz.

Sp. gr.

Urea.

251022 310.75 June 20311030 137.56281026 348.04

June 21291029 218.66231026 244.95231026 328.60281028 372.68261028 300.04271026 383.40321026 454.40

ALFRED WANSTALL, M.D

Normal Under influence of drug Amt. oz.

Sp. gr.

Urea, grs.

Date Amt. oz.

Sp. gr.

Urea.

381026 370.98 June 20241028 170.46321029 241.28

June 21261030 346.13341026 452.63 June 22301030 346.13411027 564.00231027 336.93321028 454.40

EDWARD CHAPIN

Normal.

Date Amt. oz.

Sp. gr.

Urea.

June 14261025 419.29 June 17301025 355.69 June 18291026 386.06

June 19281027 385.28 June 20381025 354.11 June 22281025 360.40

June 23281023 335.48

WHEN TAKING TINCTURE OF FRESH ROOTS, FIRST TEST

Date Amt. oz.

Sp. gr.

Urea, grs.

August 14301023 386.10 August 15321024 425.92

August 16351021 419.30 August 17241024 317.04

August 18231025 316.48 August 19231025 245.00

SECOND TEST OF SAME

Date Amt. oz.

Sp. gr.

Urea, grs.

August 30201027 355.00 August 31231025 387.78

Sept. 1231027 326.00

UNDER INFLUENCE OF INFUSION OF FRESH ROOTS PREPARED WITH TEN PER CENT. OF ALCOHOL

Date Amt. oz.

Sp. gr.

Urea, grs.

Uric acid.

Grams.

P2O5

SO3 Grams.

Sept. 29341023 543.15 .08160 1.9417 1.98132

Sept. 30271025 479.25 .05468 1.9024 1.41400

Oct. 1281024 459.73 .16170 1.8823 1.46235 Oct. 2261024 334.62 .28798 2.0234 1.25857

The increase of P2O5 on the 2d is owing possibly to eating of oatmeal on the forenoon of Sunday, also on the following morning.

Remarks concerning my first test of the θ of the fresh roots.

• Please notice that the drug was first taken on the evening of August 13th, 1877, just before retiring, and the amount of urine passed the day following (August 14th) was slightly increased over the average of the normal amount. The specific gravity less than the average, and the amount of urea increased. The second day under the influence of the drug there is increased amount of urine and a marked increase in the secretion of urea. The third day more increase in amount of urine passed, and the amount of urea nearly the same as the second day. Also notice that on the morning of the third day (August 16th) I took the largest dose, and that dose was the last taken during this test. The day following (August 17th), amount of urine less than during the three preceding days while taking drug; also a decrease in secretion of urea that day (August 17th). This same decrease was marked for some two days after. Hence I conclude that during the three days while talking drug (August 14th, 15th and 16th) the average amount of urine was increased; the specific gravity decreased, and the amount of urea also increased. And the observations during the two days following the stoppage of taking the drug show that the amount of urine passed was decreased, the specific gravity increased, and the amount of urea decreased. The diarrhœa continued through the 19th of same month, and the symptoms as depicted under stools in the proving were very marked. When the normal stools were restored, the concomitant symptoms passed away. Since the disappearance of the diarrhœa the stools are so large that they cause much pain in expulsion. They do not smell so badly as previous to taking the medicine.

Had a craving appetite; food seemed to taste very good.

For some two or three nights after taking the drug had profuse perspiration.

I also had much nausea, but not associated with much retching nor any vomiting during the whole time that I was under the influence of the drug.

Had more or less pain in the back.

Feeling of weakness in the rectum, sphincter muscles feel relaxed.

Remarks on second test with θ of fresh roots.

• Since taking this last time to date (September 28th, 1877), my bowels have moved twice almost every day. Stools normal and less fetid than before taking the drug. Have noticed considerable blood on waste paper quite a number of times. The muscles of anus feel relaxed. I have also felt bearing down in rectum as if going to have piles. Anus also feels as if open. Have also noticed more flatus than usual.

Much headache, especially in right temple, this was followed by vertigo and nausea.

Have had much pain in knee joints, and the lower extremities feel stiff. Catching pains in heart, of a quick and sharp character. Some palpitation.

Have lost four pounds since taking the medicine. Appetite exceedingly good and food relishes better.

I am inclined to think from the character of stools that the drug in some way influences the secretion of bile.

Remarks on the test with hot infusion of fresh roots with 10 per cent. alcohol.

• The head and heart symptoms gradually diminishing to date (October 15th, 1877), are not now perceptible. Since the primary action of the drug on the bowels has passed away, I have had three passages almost every day, something very unusual for me, as my normal condition is only one passage per day, and that in the morning. During these days of which I speak I would feel bloated in the abdomen, with slight pains as if flatus were moving in different parts of the abdomen; this would be followed immediately by an urgent desire for stool. This desire was so sudden and urgent that I would fear that an accident might befall me. I had no control of sphincter ani muscle. These symptoms of stool always occurred immediately after eating. These stools were at times mushy, and at other times a little lumpy, associated with undigested food. These stools were painless, preceded by some pains of moving flatus, and followed by tenesmus and bearing down in rectum even to protrusion. I have also noticed considerable itching in anus. After the stool a feeling of emptiness in abdomen and some protrusion; also the characteristic pain in the right temple.

My appetite was never better than during this time.

Pain in joints, especially those of the knee, associated with sticking pains in the inferior angle of the scapula; the latter pains at times are dull and aching and last quite a long time.

Little boils on face and thighs.

I will now state (January 30th, 1878) that my bowels are regular, with one passage per day. The heart symptoms have all passed away, and the pulse is regular and normal. The only symptom that seems to remain is weakness of ani muscles; they still feel relaxed.